Percutaneous registration apparatus and method for use in computer-assisted surgical navigation
First Claim
1. An apparatus for facilitating percutaneous placement of surgical instruments into the spine, adapted for use with a surgical navigation system employing an energy-detecting array in communication with a surgical navigation computer to track positions of instruments in three dimensional space relative to a known reference point, said apparatus comprising:
- a connector adapted to be rigidly attached to a portion of the spine;
at least one central post connected to said connector;
a position identification structure rigidly and removably connected to said central post at a predetermined position on said central post and adapted to be reconnected at the same said predetermined position, said identification structure being further adapted to allow a patient to be scanned with the structure connected to the central post, said structure including an assembly for communicating positioning information with respect to said assembly to the energy detecting array and surgical navigation computer; and
a connector assembly for said reconnecting of said structure substantially to said predetermined position on said central post.
2 Assignments
0 Petitions
Accused Products
Abstract
An apparatus and procedures for percutaneous placement of surgical implants and instruments such as, for example, screws, rods, wires and plates into various body parts using image guided surgery. The invention includes an apparatus for use with a surgical navigation system, an attaching device rigidly connected to a body part, such as the spinous process of a vertebrae, with an identification superstructure rigidly but removably connected to the attaching device. This identification superstructure, for example, is a reference arc and fiducial array which accomplishes the function of identifying the location of the superstructure, and, therefore, the body part to which it is fixed, during imaging by CAT scan or MRI, and later during medical procedures.
566 Citations
43 Claims
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1. An apparatus for facilitating percutaneous placement of surgical instruments into the spine, adapted for use with a surgical navigation system employing an energy-detecting array in communication with a surgical navigation computer to track positions of instruments in three dimensional space relative to a known reference point, said apparatus comprising:
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a connector adapted to be rigidly attached to a portion of the spine; at least one central post connected to said connector; a position identification structure rigidly and removably connected to said central post at a predetermined position on said central post and adapted to be reconnected at the same said predetermined position, said identification structure being further adapted to allow a patient to be scanned with the structure connected to the central post, said structure including an assembly for communicating positioning information with respect to said assembly to the energy detecting array and surgical navigation computer; and a connector assembly for said reconnecting of said structure substantially to said predetermined position on said central post. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method for monitoring the location of an instrument, surgical implant and various portions of the body, to be operated on, using a surgical navigation system with a surgical navigation computer and a digitizer array for monitoring the location of instruments in three-dimensional space relative to a known reference point, said method comprising the steps of:
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attaching a fixture having a central post to a portion of the spine; removably attaching an identification structure including a fiducial array and a reference arc to said central post; providing a scanned three-dimensional image of a patient including said fiducial array rigidly attached to said central post of said fixture, said fixture being rigidly attached to the patient to identify the position of said fixture and said fiducial array on the scanned image; using an image-guided system, by touching an image guided surgical pointer to one or more fiducials on the fiducial array to register the location of a spinal element fixed to said array; and emitting a signal from said reference arc to indicate changes in position of the spinal element during a surgical procedure. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17)
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18. A system for use in performing the percutaneous placement of surgical implants and instruments into the spine using image guided surgery and a surgical navigation computer and energy detecting array, said system comprising:
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means for attaching a fixture to a portion of the spine; means for communicating position information to the surgical navigation computer and energy detecting array said means rigidly and removably connected to said means for attaching a fixture; means for providing location information of said spinal portion to the surgical navigation system adapted to be connected to spinal elements; means for indicating screw-head position said means electrically connected to the surgical navigation system and adapted to mate with the head of a screw implanted in one or more of said spinal elements. - View Dependent Claims (19, 20)
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21. An apparatus for use in computer assisted procedures, comprising:
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a device operable to be connected to a structure and including; a clamp operable to engage the structure having a first member and a second member to engage substantially opposite sides of the structure; a member extending from and detachably connected to the clamp; and at least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be connected to the member; wherein the first member of the clamp includes a first arm and the second member of the clamp includes a second arm operable to compress the structure therebetween to hold the device relative to the structure; wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure. - View Dependent Claims (23, 24, 25, 27, 28, 29)
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22. An apparatus for use in computer assisted procedures, comprising:
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a device operable to be connected to a structure and including; a clamp operable to engage the structure having a first member and a second member to engage substantially opposite sides of the structure; a member extending from and connected to the clamp; and at least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be detachably connected to the member; a monitor; a screw or wire positioned in a bone; and a pointer operable to touch at least one of the screw or the wire; wherein the monitor is operable to display an image of at least one of the screw or the wire and an indication of a position of at least one of the screw or the wire based on the pointer touching at least one of the screw or the wire; wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure.
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26. An apparatus for use in computer assisted procedures, comprising:
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a device operable to be connected to a structure and including; a clamp operable to engage the structure having a first member and a second member to engage substantially opposite sides of the structure; a member extending from and detachably connected to the clamp; and at least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be detachably connected to the member; a tool; a tracking device fixed to the tool to track the tool relative to the structure; and a tracking system to track the tracking device and the reference portion; wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure.
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30. An apparatus for use in computer assisted procedures, comprising:
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a device operable to be connected to a structure and including; a clamp operable to engage the structure having a first member and a second member to engage substantially opposite sides of the structure; a member extending from and connected to the clamp; and at least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be detachably connected to the member; wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure; wherein the clamp and the member are configured in a geometric orientation and location; wherein the at least one of a reference portion is operable to be detachably connected to the member or a fiducial member is operable to be detachably connected to the member with a starburst connector.
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31. An apparatus for use in computer assisted procedures, comprising:
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a device operable to be connected to a structure and including; a screw operable to be driven into the structure; a member extending and detachable from the screw; and at least one of a reference portion operable to be detachably connected to the member or a fiducial member operable to be detachably connected to the member; wherein the reference portion is operable to determine a location of the structure and the fiducial member is operable to be registered relative to an image of the structure. - View Dependent Claims (32, 33, 34, 35, 36, 37)
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38. A method of registering a physical space defined relative to a subject to an image space of the subject, comprising:
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fixing a clamp to a structure of the subject; fixing a fiducial portion to the clamp with a connector; acquiring image data of the subject and the fiducial portion connected to the subject; removing the fiducial portion from the clamp after acquiring the image data; registering the subject space to the image space of the acquired image data, including; reattaching the fiducial portion to the clamp in a same geometric orientation and location as during the acquiring the image data; determining a location of a registration portion of the fiducial portion. - View Dependent Claims (39, 40, 41, 42, 43)
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Specification